Alcohol use and its association with dementia among older persons in northern and southwestern Uganda: a case-control study

Alcohol use is a major modifiable risk factor for dementia. However, there is a paucity of literature on alcohol use and the development of dementia in sub-Saharan Africa, especially in Uganda. This study investigated alcohol use and the development of dementia among older persons in rural Uganda. A community-based case-control study among 588 older persons aged 60 years and above in Northern and Southwestern Uganda. Using the IDEA cognitive screening tool (294 Cases and 294 controls) older persons were enrolled. Interview data were collected using a questionnaire. Data were entered in EpiData version 3.0, cleaned, and transferred to SPSS version 26.0 for statistical analysis. Logistic regression was used to determine the risk of development of dementia at a 95% confidence interval. In this study, the proportion of participants reporting alcohol use was at 82.0% (482/588) among older persons aged 60 years and above in rural Uganda. Specifically, alcohol exposure was higher among cases at 85.7% (252/294), compared to 78.2% (230/294) among controls. Alcohol exposure was significantly associated with 1.67-fold increase in the odds of possible dementia among older persons in rural Uganda [cOR:1.67, CI:1.08–2.56, p = 0.018]. Furthermore, alcohol use for more than 10 years [cOR:2.15, CI:1.27,3.64, p = 0.005], no formal education [aOR:2.03, CI:1.37,3.01, p < 0.001], and physical inactivity [aOR:1.84, CI:1.30,2.61, p = 0.001] were significantly associated with increased odds of being a case among older persons 60 years and above. In this study, alcohol exposure between cases and controls is substantially high and is significantly associated with increased odds for being a case among older persons in rural Uganda. Furthermore, alcohol use for more than ten years, lack of formal education, and physical inactivity were significantly associated with increased odds for being a case among older persons. These findings highlight the need for community-based interventions that reduce harmful alcohol use, promote lifelong learning, and encourage physical activity among older adults.